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We retrospectively evaluated demographic and biochemical parameters associated with depression and health-related quality of life (HRQOL) in maintenance peritoneal dialysis (PD) patients. This study included 105 patients maintaining PD at Seoul National University Hospital. Data were collected from electronic medical record. Korean Beck's Depression Inventory and Korean version of Kidney Disease Quality of Life short form, version 1.3 were used to evaluate depression and HRQOL, respectively. Moderate to severe depression was found in 24.8% of patients. Patients with lower normalized protein equivalent of nitrogen appearance (nPNA) (< 1.2 g/kg/day), lower weekly renal Kt/Vurea (< 0.2), and lower serum albumin level (≤ 4.0 g/dL) were associated with depression (P < 0.05). Among them, lower weekly renal Kt/Vurea was the only independent risk factor associated with depression (OR = 3.1, P = 0.007). Depressed patients showed significantly lower scores in every dimension of HRQOL (P < 0.001). Lower weekly renal Kt/Vurea (β = 0.24, P = 0.005) and lower nPNA (β = 0.15, P = 0.03) were the independent risk factors associated with lower kidney dialysis component summary, whereas lower plasma hemoglobin level was the consistent risk factor for lower physical component summary (β = 0.22, P = 0.03) and mental component summary (β = 0.22, P = 0.01). Depression is a prevalent psychological problem in PD population. Residual renal function is the most important factor associated with depression and impaired HRQOL in PD patients.

Background Little is known how health related quality of life (HRQOL) change in the transition from dialysis to renal transplantation (RTX). Longitudinal data addressing the patient-related outcomes are scarce, and particularly data regarding kidney-specific HRQOL are lacking. Thus, the aim of the current study was to assess HRQOL in patients followed from dialysis to RTX. Furthermore, to compare HRQOL in RTX patients and the general population. Methods In a prospective study, HRQOL was measured in a cohort of 110 patients (median age 53.5 (IQR 39–62) years, GFR 54 (45–72) ml/min/1.73 m2) in dialysis and after RTX using the self-administered Kidney Disease and Quality of Life Short Form version 1.3 (KDQOL-SF). Generic HRQOL in the RTX patients was compared to that of the general population (n = 5903) using the SF-36. Clinical important change after RTX was defined as difference in HRQOL of SD/2. Results Follow-up time was 55 (IQR 50–59) months, and time after RTX was 41 (34–51) months. Four of nine domains in kidney-specific HRQOL improved after RTX, i.e. burden of kidney disease, effect of kidney disease, symptoms and work status. In SF-36, general health, vitality, social function and role physical improved after RTX, but none of the domains improved sufficiently to be regarded as clinically relevant change. There were highly significant differences in HRQOL between RTX patients and the general population after adjustment for age and gender for all items of SF-36 except for bodily pain and mental health. Conclusions HRQOL improved in the transition from dialysis to transplantation, but clinical relevant change was only obtained in the kidney specific domains. HRQOL was perceived considerably poorer in RTX patients than in the general population. Our observations point to the need of improving HRQOL even after RTX, and should encourage further longitudinal research and clinical attention during treatment shift.

Este artigo pretende descrever e comparar a qualidade de vida relacionada com a saúde nas pessoas com insuficiência renal crónica em diálise de acordo com os diferentes tipos de admissão. Foi desenvolvido um estudo não experimental, transversal e descritivo numa amostra de 231 pessoas com insuficiência renal crónica, conforme o tipo de admissão à diálise e que efectuavam tratamento dialítico no nordeste transmontano. Utilizou-se o instrumento de medição KDQOL constituído por uma medida genérica de saúde - o SF-36 - e uma específica deste quadro clínico - o ESRD. Dos participantes estudados, a maioria era do sexo masculino (56,3%), casados (68,4%), reformados ou pensionistas (84,9%), provenientes de zona rural (67,4%) e com um nível de instrução básico ou inferior (89,1%). A idade dos respondentes variou entre os 18 e os 88 anos, com uma média de 61,6 anos e uma mediana de 65 anos. O tempo de diálise destes doentes foi entre 15 dias e 24 anos e o tipo de tratamento mais prevalente foi a hemodiálise (94,8%). A maior parte dos doentes apresentou outras doenças associadas (56,3%) e complicações (91%), tendo sido a diabetes a doença associada mais referida (26,4%) e o cansaço (69,7%), as mãos e pés adormecidos (58,9%), as cãibras (54,5%), as dores musculares (52,4%) e a comichão (51,5%), as complicações mais assinaladas. Os doentes com admissão programada para diálise apresentaram uma qualidade de vida mais satisfatória do que os admitidos de forma urgente, com diferenças estatisticamente significativas na actividade profissional, no desempenho físico, no desempenho emocional, na função social e na vitalidade. Os resultados evidenciaram também um impacto negativo de algumas variáveis sócio-demográficas e clínicas. Nesta investigação é reconhecida a importância da avaliação da qualidade de vida relacionada com a saúde, como um indicador de excelência dos cuidados de saúde, reflectindo a voz do utente.

OBJETIVO: Realizar a tradução para o português e a adaptação cultural do instrumento Kidney Disease Quality of Life Short Form - KDQOL-SF TM para sua posterior validação no Brasil. MÉTODOS: O instrumento foi traduzido da versão original (Inglês) para a língua portuguesa pelos autores e por tradutor juramentado e, posteriormente, revisado e avaliado quanto ao grau de dificuldade das traduções e equivalência por tradutor especialista. O instrumento foi, então, aplicado em 30 pacientes com insuficiência renal crônica terminal, em tratamento dialítico, selecionados aleatoriamente. RESULTADOS: A idade média dos pacientes foi 47±9 anos (variação, 23 a 60 anos), com escolaridade básica incompleta em 53% deles, sendo 60% do sexo feminino. A maioria dos pacientes (63%) realizava hemodiálise e o período de tratamento nos 30 dias antecedentes à aplicação do questionário foi de pelo menos 12 horas ou mais por semana. O tempo de tratamento dialítico era de 0-2 anos para 70% dos pacientes. A viabilidade do instrumento e as dificuldades encontradas pelos pacientes foram avaliadas por um painel de profissionais e as mudanças foram feitas baseadas nas dificuldades de compreensão. As atividades do instrumento original incompatíveis com atividades realizadas habitualmente pela população brasileira foram substituídas. Foram modificadas expressões da tradução, por termos sugeridos pelos pacientes e especialistas brasileiros e a explicação de cinco itens foi colocada entre parênteses para facilitar a compreensão. As palavras de uso comum da língua portuguesa foram mantidas. CONCLUSÃO: A tradução e a adaptação cultural do questionário KDQOL-SF para o português foram realizadas, tendo sido cumprida esta importante etapa para sua validação e utilização em nosso meio. BACKGROUND: The objective of this study was to translate from English into Portuguese and to perform cultural adaptation of the Kidney Disease Quality of Life Short Form - KDQOL-SF TM to make possible its validation in Brazil. METHODS: This instrument was translated from the original English version into Portuguese language by the authors and it was also translated by a certified translator and revised by a specialized translator who evaluated the level of difficulty for translation. Thirty end-stage renal disease patients undergoing dialysis were randomly selected to participate in the study. RESULTS: The mean age of patients was 47±9 years (23 to 60 yr), and the predominant education level was incomplete elementary school (1st to 8th grade=53%); 60% of the patients were female. The majority of patients (63%) were undergoing hemodialysis and the period of treatment within the last 30 days was 12 hours or more per week. The time of dialysis treatment was 0-2 years for 70% of the patients. The feasibility of the instrument and the difficulties found by the patients were evaluated by a panel of experts and changes were made regarding difficulties of comprehension. Some activities were substituted since they were not regular for the Brazilian population. There were modifications in expressions of translation for terms suggested by patients and Brazilian experts and, for five items it was suggested to include an explanation in parentheses. Common words used in the Portuguese language were chosen. CONCLUSIONS: The translation and cross-cultural adaptation of the KDQOL questionnaire to Portuguese were concluded, having been accomplished this important stage for its validation and use in our environment.